Background: Endothelial dysfunction is thought to be a key event in the development of atherosclerosis. Demonstration of increased endoglin expression in atherosclerotic plaques suggested participation of endoglin in atherogenesis. Endoglin expression was also related to nitric oxide (NO) production in endothelium.
Objective and hypotheses: Aim of the study was to evaluate the subclinical atherosclerosis in adolescents with type 1 diabetes mellitus (T1DM) by non-invasive radiological methods including flow-mediated dilation (FMD) of the brachial artery and measurement of intimamedia thickness (CIMT) of the carotid arteries along with serum endoglin and plasma nitric oxide levels.
Method: 58 patients with moderately controlled T1DM (57% male, age 15.34±1.79, and diabetes duration 6.71±0.49) and 29 healthy controls (51% male, age 15.03±2.00) participated in the study. Serum endoglin, plasma NO, FMD, and CIMT were measured and compared between study and control groups. Patients with microvascular complications (MiC) were further compared with those without, and controls. Serum endoglin was measured by ELISA Kit and plasma NO by colori assay kit.
Results: Mean serum endoglin and plasma NO levels were found significantly increased in adolescents with diabetes as compared to the control group (2.61±0.67 vs 1.97±0.45 μg/ml, P=0.001; 4.68±2.01 vs 3.74±1.64 μg/ml, P=0.033 respectively). CIMT and FMD (%) insignificantly differed between patient and control groups (P>0.05). Diabetic patients with MiC had lower endoglin level than the patients without MiC whereas higher endoglin level than the control group. CIMT was found significantly higher in patients with MC than diabetic patients without MC and controls. Significantly higher NO level was found in patients with MC as compared to the control group.
Conclusion: Subclinical atherosclerosis should be investigated in diabetic adolescents particularly with microvascular complications. The levels of biomarkers reflecting endothelial dysfunction may change during the progression of the disease. Further studies are warranted to clarify causeeffect relationship.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology